HEALTH

"Leading Local Change" (NHS Next Stage Review)

Alan Johnson: In my oral statement of 10 October 2007, Official Report, column 297, I notified the House that my noble Friend Lord Darzi had published an interim report as part of the NHS Next Stage Review. I am writing to update the House on the progress of the review as Lord Darzi has today published "Leading Local Change".
	The Prime Minister and I asked Lord Darzi to lead the review in July 2007. His interim report in October set out a vision for a world class NHS that is fair, personal, effective and safe.
	The review has been led locally by clinicians in each NHS region. Seventy-four local clinical working groups, made up of some 2,000 clinicians, have been looking at the clinical evidence and engaging with their local communities. They have developed improved models of care for their regions to ensure that the NHS is up to date with the latest clinical developments and is able to meet changing needs and expectations.
	Lord Darzi is today publishing "Leading Local Change" to set the context for these local visions and the principles which will guide their implementation. We are also publishing new operational guidance, as promised in October's interim report, to help ensure that any changes are based on clinical evidence and are in the best interest of patients. As part of this, we are making five pledges on change in the NHS, which primary care trusts will have a duty to have regard to:
	change will always be to the benefit of patients. This means that they will improve the quality of care that patients receive—whether in terms of clinical outcomes, experiences, or safety;
	change will be clinically driven. We will ensure that change is to the benefit of patients by making sure that it is always led by clinicians and based on the best available clinical evidence;
	all change will be locally-led. Meeting the challenge of being a universal service means the NHS must meet the different needs of everyone. Universal is not the same as uniform. Different places have different and changing needs—and local needs are best met by local solutions;
	local communities will be involved. The local NHS will involve patients, carers, the public and other key partners. Those affected by proposed changes will have the chance to have their say and offer their contribution. NHS organisations will work openly and collaboratively; and
	local communities will see the difference first. Existing services will not be withdrawn until new and better services are available to patients so they can see the difference.
	The nine strategic health authorities (SHAs) outside London will be publishing their strategic visions for improving health and healthcare in their regions over the coming weeks in accordance with the following timetable.
	The SHA strategic visions will be published as follows:
	
		
			 12 May East of England 
			 14 May Yorkshire and Humber 
			 15 May South West 
			 19 May South Central 
			 20 May North West 
			 22 May North East 
			 2 June South East Coast 
			 3 June West Midlands 
			 5 June East Midlands 
		
	
	Lord Darzi will publish his final report in June. It will be designed to enable and support the improvements that have been determined locally in the SHA strategic visions.
	I firmly believe that this approach, led by clinicians, based on clinical evidence and strong engagement with local communities, is how changes to the NHS should take place as we move from an NHS that is world class in many aspects to one which is world class in everything it does.

WORK AND PENSIONS

Correction to Written Answer

James Plaskitt: It has been brought to my attention that the reply I gave the hon. Member for Epsom and Ewell, (Chris Grayling), 1 April 2008, Official Report, columns 780-81W, omitted the information about contributory jobseeker's allowance. I apologise for this oversight.
	The correct answer should have been:
	Neither income related jobseeker's allowance, nor income support are payable to people who live outside Great Britain. Contributory jobseeker's allowance can, under certain circumstances, be exported to other European economic area countries and Switzerland. Further, 0.45 per cent. only of incapacity benefits claimants live abroad.
	An EC regulation co-ordinates member states' social security schemes for workers who move between member states. The EC regulation provides that generally, sickness and invalidity benefits must be exported if a beneficiary moves to another member state, although there are some restrictions on the export of sickness benefit. In effect, people in Great Britain who qualify for contributory incapacity benefit (IB) because they have made sufficient national insurance contributions, can continue to receive their benefit if they take up permanent residence in one of the other EU member states. The agreement also extends to the states of the European economic area (EEA) and Switzerland. The UK also has reciprocal arrangements with a number of non-European countries (e.g. USA, Jamaica) some of which include similar arrangements for people from Great Britain to continue to receive contributory benefit when they move there and vice versa.
	Of those receiving IB abroad most live in the Republic of Ireland and Spain and smaller numbers across a wide range of other European countries. Very few live outside Europe. They include both British expatriates and nationals of other countries who have worked and paid contributions in Great Britain and have then returned to their own country. They also include "pro rata" cases where the benefit is paid partly by the UK and partly by a foreign authority as customers have contributed to insurance schemes in both Great Britain and an EEA state.
	Information is not available for exported jobseeker's allowance other than at disproportionate cost. The available information for incapacity benefits is in the table.
	
		
			 Incapacity Benefit and Severe Disablement Allowance Claimants in Great Britain and Abroad; as at May each year 
			 Quarter ending GB Claimants living abroad 
			 1998 2,784,500 9,400 
			 1999 2,744,300 9,000 
			 2000 2,728,090 10,230 
			 2001 2,795,340 10,430 
			 2002 2,807,630 10,800 
			 2003 2,815,660 11,300 
			 2004 2,814,710 11,740 
			 2005 2,783,720 12,130 
			 2006 2,730,000 12,050 
			 2007 2,685,320 12,010 
			 Notes: 1.Caseload figures prior to May 2000 are rounded to the nearest 100, and to the nearest 10 thereafter. 2. Incapacity benefit (IB) and severe disablement allowance (SDA) claimant figures include IB credits only cases. 3. Caseload figures prior to May 2000 have been produced using 5 per cent. data and rated up proportionally using 100 per cent. WPLS totals. 4. Great Britain totals may include a small number of claimants living abroad. 5. It is possible to receive IB/SDA in another country in the European economic area (EEA) or a country which has a social security agreement with the United Kingdom, or short-term IB for up to 26 weeks under certain conditions. Source: IAD Information Centre 5 per cent. samples—May 1998 to May 1999 and DWP Information Directorate, Work and Pensions Longitudinal Study, 100 per cent. data—May 2000 onwards.

National Insurance Numbers

Stephen Timms: Over the course of 2008 the Government are reintroducing procedures to count foreign nationals in and out of the UK. We are introducing ID cards for foreign nationals, on a compulsory basis, to guard against fraudulent access to jobs and benefits. As part of our cross-governmental enforcement strategy, the DWP will further tighten the criteria for national insurance number (NINO) allocation to ensure that where the partner of a legitimate benefit claimant has no right to be in the UK, DWP will no longer issue the partner with a NINO. This follows the successful introduction of right to work interviews for those applying for national insurance numbers in 2006.
	This change will be made using the regulation-making powers under section 1 of the Social Security Administration Act 1992. The intention is that regulation changes will be introduced at the earliest opportunity.